title: Renal-related biomarkers and long-term mortality in the US subjects with different coronary risks.
abstract: OBJECTIVE
  The objective was to evaluate the association of a panel of renal biomarkers with long-term mortalities.
  
  
  METHODS
  Participants in the Third National Health and Nutrition Examination Survey (NHANES III) aged 35 years and above were included and Framingham risk scores were calculated. Renal-related biomarkers, including creatinine-based estimated glomerular filtration rate (eGFR), cystatin C, uric acid, C-reactive protein (CRP), fibrinogen, urinary cadmium, albuminuria, homocysteine, and vitamin D were tested by Cox-regression model for their association with all-cause, cardiovascular (CV), and non-CV mortality obtained from the 2006 NHANES III-linked follow-up data, stratified by sex and Framingham risk.
  
  
  RESULTS
  In the 4873 men and 5372 women, 36.3%, 28.1%, and 35.6% of men and 67.2%, 25.8%, and 7.0% of women were classified into low-, intermediate-, and high coronary risk groups. With an average follow-up of 13.2 years, a total of 3632 deaths and 1657 CV deaths were recorded. Albuminuria was associated with all-cause mortality in both sexes across coronary risk groups. Creatinine-based eGFR provided additional differential capacity only in the women with intermediate-to-high coronary risk. Cystatin C was associated with all-cause mortality in the men with intermediate-to-high coronary risk and with CV mortality in the women with low coronary risk. Urinary cadmium was positively related to non-CV mortality. High vitamin D was protective against cardiovascular mortality in a limited category of men and women.
  
  
  CONCLUSIONS
  Albuminuria is associated with long-term all-cause mortalities independent of Framingham risks. Adding the panel of renal biomarkers provides limited advantages for predicting risk when compared to FRS alone.
authors.affiliation: Cardiovascular Center and Health Management Center, National Taiwan University Hospital Yun-Lin Branch, Dou-Liou City, Taiwan.
authors.forename: Cho-Kai
authors.initials: CK
authors.lastname: Wu
authors.forename: Man-Huei
authors.initials: MH
authors.lastname: Chang
authors.forename: Jou-Wei
authors.initials: JW
authors.lastname: Lin
authors.forename: James L
authors.initials: JL
authors.lastname: Caffrey
authors.forename: Yu-Sheng
authors.initials: YS
authors.lastname: Lin
mesh_terms: D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000097:blood / Q000401:mortality* / Q000503:physiopathology; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D003327:Coronary Disease / Q000097:blood / Q000401:mortality* / Q000503:physiopathology; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000503:physiopathology; D007674:Kidney Diseases / Q000097:blood / Q000401:mortality* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D011379:Prognosis; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012307:Risk Factors; D016019:Survival Analysis; D013997:Time Factors; D014481:United States / Q000453:epidemiology
chemical_list: D015415:Biomarkers